Large cell carcinoma of the lung differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Large cell carcinoma of the lung must be differentiated from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly from other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.[1][2]

Differential Diagnosis

  • The table below summarizes the findings that differentiate large cell carcinoma of the lung, from other diseases that cause non-productive cough, weight loss, fatigue, and dyspnea among adults such as tuberculosis, pulmonary fungal disease, lung abscess, and more importantly other causes of non-small cell lung cancers, such as adenocarcinoma and squamous cell lung cancer.[1][2]
Differential Diagnosis Similar Features Differentiating Features
Pulmonary tuberculosis
  • Cough, weight loss, fatigue, and dyspnea
  • In pulmonary tuberculosis, differentiating features include: size increase despite optimal medical therapy, patients age is usually younger, hemoptysis is an early feature, and CXR anatomical predilection for upper lobes
Lung abscess
  • Non-productive cough, weight loss, and chest pain
  • In lung abscess, differentiating features include: acute or sub-acute onset, CXR anatomical predilection for upper lobes, and usually resolve with antibiotic
Pneumonia
  • Cough, weight loss, fatigue, and dyspnea
  • In pneumonia, differentiating features include: good response to antibiotics, acute onset, predilection on CXR is consolidation, laboratory markers indicate infection
Pulmonary fungal infection
  • Non-productive cough, weight loss, fatigue, and dyspnea
  • In pulmonary fungal infection, differentiating features include: CXR findings: air-cresecent sign, no response to antibioitcs, and mimics tuberculosis
Other non-small cell lung cancers
  • Non-productive cough, weight loss, fatigue, and dyspnea
  • In other non-small cell lung cancers , differentiating features include: histopathologica features, such as larger size of the anaplastic cells, a higher cytoplasmic-to-nuclear size ratio, and a lack of "salt-and-pepper" chromatin

References

  1. ↑ 1.0 1.1 Bhatt M, Kant S, Bhaskar R (2012). "Pulmonary tuberculosis as differential diagnosis of non-small cell lung cancer". South Asian J Cancer. 1 (1): 36–42. doi:10.4103/2278-330X.96507. PMC 3876596. PMID 24455507.
  2. ↑ 2.0 2.1 Singh VK, Chandra S, Kumar S, Pangtey G, Mohan A, Guleria R (2009). "A common medical error: lung cancer misdiagnosed as sputum negative tuberculosis". Asian Pac. J. Cancer Prev. 10 (3): 335–8. PMID 19640168.


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